RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXX	CASE:  PD-2014-03367
BRANCH OF SERVICE:  Navy	SEPARATION DATE:  20060316

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, Fire Controlman, medically separated for “left foot pain status post open reduction internal fixation 2nd, 3rd and 4th metatarsal fractures,“ with a disability rating of 20%.

CI CONTENTION:  The CI requested review of all his conditions. His complete submission is at Exhibit A.  

SCOPE OF REVIEW:  The Board’s scope of review is defined in DoDI 6040.44.  It is limited to those conditions determined by the Physical Evaluation Board (PEB) to be unfitting for continued military service and when specifically requested by the CI, those conditions identified by the PEB, but determined to be not unfitting.  Any conditions outside the Board’s defined scope of review and any contention not requested in this application may remain eligible for future consideration by the Board for Correction of Military Records.  Furthermore, the Board’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections, where appropriate.  The Board’s assessment of the PEB rating determinations is based upon a review of medical records and all available evidence for application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) standards to the unfitting medical condition at the time of separation.  The Board has neither the role nor the authority to compensate for post-separation progression or complications of service-connected conditions.  That role and authority is granted by Congress to the Department of Veterans Affairs, operating under a different set of laws.  The Board gives consideration to VA evidence, particularly within 12 months of separation, but only to the extent that it reasonably reflects the severity of the disability at the time of separation.   

RATING COMPARISON:

SERVICE PEB – 20060202	VARD - 20060921	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Left Foot Pain S/P ORIF 2nd, 3rd and 4th Metatarsal Fracture	5299-5284	20%	Residuals, Fracture 2nd, 3rd, and 4th Metatarsals and Excision Plantar Facial Fibromatosis, Left Foot	5284	0%	20060523	
Plantar Fibromatosis	Cat II					
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  0%	

ANALYSIS SUMMARY:  

Left Foot Pain (subsumes Plantar Fibromatosis).  According to service treatment records and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI sustained a sport-related injury resulting in multiple fractures of the left foot in July 2004.  He underwent surgical fixation in August 2004 and during rehabilitation he developed plantar fibromatosis (growths at bottom of foot) which were surgically removed in April 2005.  Despite physical therapy and limited duty, the left foot condition could not be adequately rehabilitated to meet the physical requirements of the CI’s military specialty and he was referred for an MEB.  The MEB forwarded “pain in soft tissues of limb” for PEB adjudication.  At the MEB NARSUM examination performed 8 December 2005 (3 months prior to separation), the CI reported left foot pain with brisk walking or running.  He denied distal areas of numbness or tingling.  His physical examination (PE) revealed a normal walking gait and tenderness about the mid-left foot.  During the VA Compensation and Pension (C&P) examination performed on 23 May 2006 (2 months after separation), the CI reported left foot pain with running, but otherwise “…he has minor discomfort which he has learned to live with.”  He denied foot weakness.  His PE was detailed and reported as normal, including gait.     

The Board directed attention to its rating recommendation based on the above evidence.  The PEB assigned a 20% rating coded analogously 5299-5284 (foot injury, other).  The VA assigned a 0% rating also coded 5284 based on the VA C&P examination 2 months after separation, citing an absence of moderate symptoms.  Board members agreed that in this case the clinical evidence in the above examinations would not equate to a VASRD impairment rating higher than the PEB’s current 20%.  Therefore, all evidence considered, there is not reasonable doubt in the CI’s favor supporting a change from the PEB’s 20% rating decision for the left foot pain condition.

BOARD FINDINGS:  In the matter of the left foot pain condition and IAW VASRD §4.71a, the Board unanimously recommends no change in the PEB adjudication.  There were no other conditions within the Board’s scope of review for consideration.  The Board, therefore, recommends that there be no modification or re-characterization of the CI’s disability and separation determination. 

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20140605, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

MEMORANDUM FOR DIRECTOR, SECRETARY OF THE NAVY COUNCIL OF REVIEW
               BOARDS 

Subj:  PHYSICAL DISABILITY BOARD OF REVIEW (PDBR) RECOMMENDATIONS
 
Ref:   (a) DoDI 6040.44
       (b) CORB ltr dtd 21 Sep 16

      In accordance with reference (a), I have reviewed the cases forwarded by reference (b), and, for the reasons provided in their forwarding memorandums, approve the recommendations of the PDBR that the following individual’s records not be corrected to reflect a change in either characterization of separation or in the disability rating previously assigned by the Department of the Navy’s Physical Evaluation Board:

		- XXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXX, former USN
		- XXXXXXXXXXXXXXXXXXXX, former USN